Educating Health Care Professionals to Provide Institutional Changes in Cancer Survivorship Care

Abstract

The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E. Stovall (Eds.), (pp. 9–186). Washington DC: The National Academies Press, 2006) identifies the key components of care that contribute to quality of life for the cancer survivor. As cancer survivorship care becomes an important part of quality cancer care oncology professionals need education to prepare themselves to provide this care. Survivorship care requires a varied approach depending on the survivor population, treatment regimens and care settings. The goal of this program was to encourage institutional changes that would integrate survivorship care into participating centers. An NCI-funded educational program: Survivorship Education for Quality Cancer Care provided multidiscipline two-person teams an opportunity to gain this important knowledge using a goal-directed, team approach. Educational programs were funded for yearly courses from 2006 to 2009. Survivorship care curriculum was developed using the Quality of Life Model as the core around the IOM recommendations. Baseline data was collected for all participants. Teams were followed-up at 6, 12 and 18 months postcourse for goal achievement and institutional evaluations. Comparison data from baseline to 18 months provided information on the 204 multidiscipline teams that participated over 4 years. Teams attended including administrators, social workers, nurse practitioners, registered nurses, physicians and others. Participating centers included primarily community cancer centers and academic centers followed by pediatric centers, ambulatory/physician offices and free standing cancer centers. Statistically significant changes at p=<0.05 levels were seen by 12 months postcourse related to the effectiveness, receptiveness and comfort of survivorship care in participant settings. Institutional assessments found improvement in seven domains of care that related to institutional change. This course provided education to participants that led to significant changes in survivorship care in their settings.

Development and preliminary testing of PROGRESS: a Web-based education program for prostate cancer survivors transitioning from active treatment

“…These challenges include physical side effects, such as urinary, sexual and bowel dysfunctions [8]; psycho-social changes, such as anxiety, depression, and adjustment problems [9-13]; interpersonal issues, such as difficulties in patient-provider communication and disruption of intimate relationships with spouses and partners due to sexual dysfunctions and disease experiences [14, 15]; and practical issues, such as financial strain, medical insurance for future medical care, and obtaining legal assistance in cases of discriminatory workplace practices [16-18]. Although these complications can be difficult for patients to manage, there has been a paucity of healthcare resources to address patients' informational and psychosocial needs, beginning with the transition from active treatment to survivorship [19-21].…”

Facilitating survivorship program development for health care providers and administrators

“…Course and faculty evaluations were favorable across all courses and were reported previously [11]. Overall course score averages were measured on a 0 – 5 scale (0=Not at all to 5=extremely satisfied).…”

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“…At the 2-month follow-up, the intervention group reported they were more likely to ask about CAM use than the control group, but there was no significant difference in the number of patients who indicated they were asked about CAM use. Twelve months after participation in Grant’s [15] 2.5 day in-person cancer survivorship care training program the effectiveness, receptiveness, and comfort of survivorship care were significantly higher than baseline.…”